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2015 HSR&D/QUERI National Conference Abstract

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3180 — Rural Veterans' Uses of and Preferences for Communications Technology in Support of Heart Failure Self-Care in the VA Palo Alto Healthcare System

Oliva NL, VAPAHCS-Cardiology/UCSF Institute for health & Aging; Heidenreich P, CHF-QUERI/VAPAHCS/Stanford University School of Medicine;

Objectives:
Heart failure (HF) is the top reason for discharge for Veterans treated in the VA healthcare system and among Medicare patients. Rural Veterans in the VAPAHCS can benefit from ongoing guidance and support for evidence-based HF self-care in their communities, where travel barriers of up to 6-8 hours roundtrip can impede access to needed VA specialty care. The primary goal of the project was/is to learn which communications technologies rural Veterans with HF and family caregivers currently use and prefer to use for receiving health information to help them manage their health.

Methods:
A total of 193 VA-enrolled Veterans (average age:77) with a primary or secondary HF diagnosis, living in the three rural counties of the VAPAHCS and receiving VA services over the previous 24 months were mailed the 15-question self-report survey in November/December 2014. The 8th grade reading-level survey addressed existing/preferred methods of receiving basic/heart health information, as well as access to fixed and mobile communications technology.

Results:
Veterans with an average age of 76 returned 101 responses, reflecting a 52% response rate. Veterans were asked to choose one/more of five technical communication methods that they would be willing to use in receiving health information/support from the VA to care for their health: email; landline call; Cell-phone/Smartphone call; Cell/Smartphone text; and/or US MAIL. Of the five methods, the US Mail was the most frequently endorsed method (84%), followed by email (46%), and calls to Veterans' landline phones (40%). Veterans were least likely to select calls to their cell phone/Smartphone (14%) or texting to their Cell phone/Smartphone (9%). While 68% of respondents had in-home internet access via PC, tablet or Smartphone technology, few reported using the internet for obtaining basic health information (17%) or heart health information (4%). Seventy percent (70%) of respondents reported having Cell phones, and 20% reported having a Smartphone. A minority of Cell/Smartphone users (25%) reported using their mobiles for texting, most often daily or every few days (72%).

Implications:
Survey results reflect respondents' preferences for US Mail, email, and voice phone-based methods of delivering self-care information/support.

Impacts:
Disease self-care information/support can be provided via asynchronous US Mail methods, as well as engaging real-time methods of email and voice communication, and to a lesser extent, mobile device texting. These methods can reduce Veterans' barriers to accessing specialty care and self-care support for HF or other chronic diseases.